The corticosteroids are the firstline therapeutical agents for noninfectious uveitis patients, but systemic corticosteroids are ineffective for some chronic or recurrent patients, and have many long term usagerelated side effects; these patients may need treatment of immunosuppressive agents and/or biologic agents. However, the mechanism, indication, efficacy and sideeffects of each type of the immunosuppressive agents or biologic agents are not identical. In clinical practice, we should use different and sensitive immunosuppressive agents or biologic agents for different types of uveitis, and watch their efficacy and toxic effects closely. In order to improve the effectiveness of the treatment, the classification, efficacy and existing concerns of commonly used uveitis drugs need to be further clarified.
Objective To explore the frequency, clinical features, and characteristics of results of fundus fluorescein angiography (FFA) of uveitis related cystoid macular edema (CME). Methods The clinical data and FFA results of 67 patients (106 eyes) with posterior uveitis examined in our hospital from July 2002 to June 2005 were collected. The clinical features and characteristics of FFA images of CME were observed and analyzed. Results Among the106 eyes of 67 patients with uveitis,the CME was observed in 28 eyes (26.4%) of 18 patients, including 7 males and 11 females with the average age of (42.5plusmn;10.8) years. The dark area due to the choroidal fluorescence blocked by the macular edema was found at the early FFA phase, and th en followed by the punctate and sheetlike leakage of fluorescein; the capillar y was dilated at the venous phase, and the typical petaloid appearance was seen at the late phase because the fluorescein cumulated in several small vesicles in the macular area. After treated by corticosteroids and topical non-steroidal anti-inflammatory medicine and carbonic anhydrase inhibitors, the extent of CME diminished, and the visual acuity improved in varying degrees. Conclusi ons Uveitis may seriously harm the visual function, in which CME induces the damage of visual acuity. Early detection and timely treatment may prevent thepermanent visual damage. (Chin J Ocul Fundus Dis, 2006, 22: 394-396)
Objective To evaluate the clinical characters of retinal arterial macoraneurysms. Methods The routine eye examination and fundus fluorescein angiography in 15 cases with macroraneurysms were reviewed. Results The macroaneurysms in the first, second and third bifurcation were 6,7 and 2 cases respectively.The macroaneurysms in the superio-temporal and inferio-temporal artery were 4 and 10 cases respectively.There was on case in both superio and inferio-temporal artery.The number of macroaneurysms was single in unitary-form were 13 cases.The diameter of the macroaneurysms were between 250～500 mu;m. Conclusions The FFA is helpful in diagnosis of macroaneurysms,and treatmnet of laser photocoagulation for the bleeding endangering the macular area. (Chin J Ocul Fundus Dis, 2001,17:207-209
Objective To examine the role of recombinant interleukin-10 (IL-10) and the therapeutic effect of endotoxin-induced uveitis (EIU) in rats.Methods Fifty-six male Wistar rats were randomized into three groups. IL-10 treatment group and positive control group had 24 rats respectively, and the normal control group had eight rats. Endotoxin-induced uveitis (EIU) is an established animal model of acute ocular inflammation induced by LPS intravenous injection (1 mu;g/kg). The onset times and signs were observed and the clinical scores were recorded. The blood samples and the aqueous humor samples of right eye were collected separately before the rats were sacrificed at fourth hour, 24th hour and third day after LPS injection. The enzyme-linked immunosorbent assay was used to measure tumor necrosis factor (TNF) alpha;,IL-6, and IL-10 levels in the serum and aqueous humor. The left eyes were used for pathological examination and pathological grading. Results The symptoms of uveitis were appeared in all 24 rats in the positive group. The average onset time was (3.81plusmn;1.05) hours, the average clinical score was 3.67plusmn;1.97. The mild manifestations of uveitis were also appeared in all of the rats in treatment group. The average onset time was (5.63plusmn;1.02) hours, the average clinical score was 2.00plusmn;1.25. The average onset time in treatment group was postponed compared with the rats of positive group (t=4.95, P=0.000). The clinical scores (t=3.50, P=0.00) and the pathological grades (t=3.28, P=0.00) in treatment group were lower than those of positive group. There were not signs or pathologic changes in all the eight rats in the negative control group. The serum and aqueous humor levels of TNF-alpha; and IL-6 in the rats of positive group were higher than those of the treatment group and control group (F=15.34, 57.65, 67.59, 8.42; P=0.00). The serum and aqueous humor levels of IL-10 in the rats of treatment group were higher than those of the positive group and the control group (F=17.84,7.76; P=0.00). There were positive correlations between the level of aqueous humor TNF-alpha;, serum and aqueous humor levels of IL-6 and the disease severity (reye＝0.58, 0.31,0.81, rpath＝0.56, 0.31, 0.74; P＜0.05). The negative correlations were presented between the serum levels of IL-10 with the disease severity (r=-0.54,-0.55; P=0.00). There were negative correlations between the serum and aqueous humor levels of TNF-alpha; and IL-6 and the onset time of the disease (r＝-0.47,-0.59,-0.77,-0.36; P＜0.05) as well. Conclusions These findings bly suggest that suppressive IL-10 is a potent candidate for the prevention of TNF-alpha; and IL-6 in uveitis and could be applied as a novel immunoregulatory agent to control EIU.
Objective To explore the clinical manifestations and the characteristics of images of indocyanine green angiography (ICGA) and fundus fluorescein a ngiography(FFA) of multifocal choroiditis. Methods Eight patie nts (10 eyes) with multifocal choroiditis were gathered. The clinical manifestations and the images of ICGA and FFA were analyzed. Results Foci of multifocal choroiditis were found in posterior pole and peripheral areas of ocular fundi of all of the 10 eyes. The images of ICGA revealed hypofluorescence in focal area. The images of FFA showed hypofluorescence at the early phase and fluorescein leakage at the late phase in the active focus, and fluorescein staining and window defect fluor escence in the inactive focus. Conclusions The clinical manife stations of multifocal choroiditis varied with disease course, location and numbers of the lesions. ICGA and FFA can show the development of the disease clearly, which may guide the treatment. (Chin J Ocul Fundus Dis，2004，20：87-89)